American Board of Internal Medicine (ABIM) Certification Practice Exam

Which conditions is NOT considered for prophylaxis with amoxicillin-clavulanate after a dog bite?

1. Moderate-to-severe wounds

2. Wounds near a joint or bone

3. Wounds on the torso

4. Wounds on the face or hand

The correct answer is: Wounds on the torso

Amoxicillin-clavulanate is often recommended for prophylactic treatment following dog bites, particularly in scenarios where the risk of infection is heightened. The decision to use antibiotic prophylaxis is guided by factors such as the severity and location of the bite wound. Wounds on the torso are generally considered to have a lower risk of developing infections that would necessitate prophylactic antibiotics compared to wounds located near joints, bones, or on the face and hand. This is primarily due to the anatomical considerations and the potential for complications in those areas. Joint and bone involvement poses a higher risk for serious infections, while bites to the face and hand can potentially lead to significant cosmetic and functional consequences which warrant preventive measures. In contrast, moderate-to-severe wounds, wounds near joints or bones, and those on the face or hand are all scenarios where prophylaxis with amoxicillin-clavulanate is recommended due to the higher risk of developing infections. Thus, choosing not to provide prophylaxis for torso wounds reflects the understanding that these wounds are less likely to result in significant complications compared to those in more critical areas.